Colles fracture and instability of wrist joint

Abstract

Objective To investigate the mechanism of colles fracture incombination with carpal joint instability and its prevention and treatment. Methods 53 cases of colles fracture were followed up for 3-5 years. Wrist joint anteroposterior and lateral view of radiography was examined at the time of pre-reduction, post-reduction and removal of extra fixation. Objective and subjective criteria was checked for function of wrist joint. Function restoration between two groups with or without wrist joint instability was compared. Results Incident of carpal instability was 41.5%(22/53), with dorsal intercalated segment instability (DISI) 10 cases (45.5%), scapholunate dissociation 12 cases (54.5%) which occurred frequently in the severe displacment caused by high energy force. Functions of wrist joint in cases with wrist joint instability were inferior to that with simple colles fracture after fracture union.Conclusions It should be noticed whether wrist joint stability was complicated in colles fracture with severe dislocation or high energy injury. For those colles fracture with wrist instability, palmar tilting angle should be restored when reduction was done. The fixation of wrist joint in neutral or light dorsal extension position (< 10°) should be recommended if the fracture was stable. If unstable fracture was present, volar flexion and ulnar deviation was fixed 2 weeks before neutral or light dorsal extension fixation(< 10°) in case of wrist instability in future. Key words: Colles fracture; Wrist joint; Recovery of function; Jointinstability